Disclaimer: I believe in medicine. I believe in procedures performed to save lives. I believe in the work that physicians and nurses do, the finances that facilitate it, and know that this does NOT apply to all healthcare professionals. This is not a knock at physicians, rather the current healthcare delivery system as a whole.
Since day one of nursing school, we have learned the importance of patient-centered care in guiding practice. Even for those not familiar with healthcare, it is pretty easy to determine what this means. The care is centered on the patient. Simple, right? For a term so easy to understand, though, it is, I think, being neglected at growing and alarming rates in today’s healthcare delivery system.
Another phrase we have repeatedly heard and have seen first-hand is “money drives healthcare.” Although the care we provide to our patients would not be possible without the appropriate funds, I can’t help but think that this phrase contradicts the guiding ideal of patient-centered care.
I am the first to admit that I don’t know nearly enough about health policy and the laws in place to guide practice. But, from the little bit that I have learned, I can’t help but wonder how we have arrived at a place in which money is the motive in caring for patients, not the patients themselves? The ideas just seem mutually exclusive to me. How have we grown to adopt such a selfish approach to healthcare?
In the majority of healthcare facilities today, physicians are paid based on the number of patients they see. Why is this the case? Why are they not paid based on the quality of care they give to their patients? To me, this policy leaves little room for the implementation of true patient-centered care. How is 5-10 minutes enough time to gather evidence, let alone do an assessment and try to get to the root of the problem? The simple solution is to write a prescription, set a follow-up appointment date, and move on to the next patient. Another check off the list, another chunk of change in their pocket. It is a revolving door and a cycle that will continue as long as we let it. In the words of one of my fellow nursing students and our favorite show Grey’s Anatomy, “the carousel never stops.” For those who think that urgent care clinics and “doc-in-the-box” facilities are the future of medicine, I encourage you to truly examine why you think so.
The future of medicine, I believe, lies in primary care. What if healthcare professionals took the time to listen to patients’ concerns, gather all appropriate evidence, and treat a condition from the roots up — not just put a bandaid on the problem? When is the government going to understand that they are ROBBING us of the ability to carry out patient-centered care to the best of our abilities? How have we come to a place in which this is acceptable? Why does a nurse spend more time on her phone at the nurses station than in her patient’s room? Why does a surgeon think it is acceptable to perform unnecessary cardiac catheterizations and pocket the rewards? I’m just a lowly nursing student and I just don’t know. But it all seems pretty selfish to me.
Our current state of healthcare delivery is unacceptable. But how can we change it? It takes healthcare professionals fully embracing why we do what we do. It takes coming to work everyday with an attitude of humble service, compassion, and excellence. It takes us refusing to surrender to the status quo of our careers and advocating for change. It goes against our human nature, but it is simply what is required to do our jobs well and provide the idealized “patient-centered care”. We have to remember that care truly is about the patient, and not at all about ourselves and our desires.
It just takes one person at a time to break the cycle.
a journey in journaling 